BBCMADE Nomogram Validation for High-Risk Gastric Content in Sedative Endoscopy (BBCMADE)
Prospective Validation of the BBCMADE Nomogram for Predicting High-Risk Gastric Content in Patients Undergoing Elective Sedative Gastrointestinal Endoscopy
調査の概要
状態
詳細な説明
Pulmonary aspiration of gastric contents accounts for 10-30% of anesthesia-related deaths. Standard fasting guidelines do not guarantee adequate gastric emptying in all patients. The BBCMADE nomogram, developed and validated by Yan et al. (2024) in a Chinese population, demonstrated high discriminatory power for predicting high-risk gastric residual content in outpatients undergoing sedative GI endoscopy. This study will prospectively evaluate its validity in a Turkish population (n=533).
The seven predictor variables (BMI, history of cerebral infarction, cirrhosis, male sex, age, diabetes, gastroesophageal reflux) will be recorded preoperatively and entered into the web-based nomogram interface. Endoscopic gastric volume measurement will serve as the gold standard. Discriminatory performance will be assessed by AUROC. Secondary analyses will include sensitivity, specificity, PPV, NPV, and subgroup analyses.
Sample size: 533 patients (prevalence ~13%, α=0.05, power=95%, 15% dropout allowance; calculated using G*Power 3).
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Bursa、トルコ(Türkiye)
- Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Türkiye
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Age 18 years or older
- ASA physical status I-III
- Scheduled for elective gastrointestinal endoscopy under sedoanalgesia
- Deemed suitable for out-of-OR anesthesia by the anesthesiology outpatient clinic
- Provision of written informed consent
Exclusion Criteria:
- Age under 18 years
- Pregnancy or suspected pregnancy
- ASA physical status IV or higher
- Emergency procedures
- Unable or unwilling to provide informed consent
- History of upper airway obstructive pathology or difficult airway
- Not eligible for out-of-OR anesthesia
- Known hypersensitivity to anesthetic agents
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
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Study Cohort
Patients scheduled for elective sedative gastrointestinal endoscopy.
Gastric volume and pH were measured endoscopically during the procedure.
Patients were classified as high or low aspiration risk based on endoscopic measurements.
The BBCMADE nomogram score was calculated for each patient and compared against the endoscopic findings to validate its predictive accuracy.
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The BBCMADE nomogram (Body Mass Index, Brain infarction, Cirrhosis, Male sex, Age, Diabetes, Esophageal reflux) is applied to predict high-risk gastric content prior to elective sedative gastrointestinal endoscopy.
Nomogram scores are compared against the gold standard endoscopic measurement of gastric volume and pH to prospectively validate the model in a Turkish population.
Gold-standard assessment of gastric contents is performed during endoscopy.
Gastric volume ≥25 mL, pH <2.5, or the presence of solid content is defined as high risk for pulmonary aspiration.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Discriminatory Performance of the BBCMADE Nomogram
時間枠:At time of procedure
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Area under the receiver operating characteristic curve (AUROC) of the BBCMADE nomogram for predicting high-risk gastric content, defined as gastric volume ≥25 mL, pH <2.5, or presence of solid content, as confirmed by endoscopic measurement.
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At time of procedure
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協力者と研究者
スポンサー
捜査官
- 主任研究者:Füsun Gözen、SBÜ Bursa Yüksek İhtisas Training and Research Hospital
出版物と役立つリンク
一般刊行物
- Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017 Mar;126(3):376-393. doi: 10.1097/ALN.0000000000001452. No abstract available.
- Yan Y, Jin Y, Cao Y, Chen C, Zhao X, Xia H, Yan L, Si Y, Zou J. Development and validation of a novel nomogram model to assess the risk of gastric contents in outpatients undergoing elective sedative gastrointestinal endoscopy procedures. Clin Res Hepatol Gastroenterol. 2024 Feb;48(2):102277. doi: 10.1016/j.clinre.2023.102277. Epub 2023 Dec 28.
- Phillips S, Liang SS, Formaz-Preston A, Stewart PA. High-risk residual gastric content in fasted patients undergoing gastrointestinal endoscopy: a prospective cohort study of prevalence and predictors. Anaesth Intensive Care. 2015 Nov;43(6):728-33. doi: 10.1177/0310057X1504300610.
- Friedrich K, Scholl SG, Beck S, Gotthardt D, Stremmel W, Rex DK; bng-Study-Group; Sieg A. Respiratory complications in outpatient endoscopy with endoscopist-directed sedation. J Gastrointestin Liver Dis. 2014 Sep;23(3):255-9. doi: 10.15403/jgld.2014.1121.233.kf1.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 2024-TBEK 2025/10-09
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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